Permit p 'CITY OF TIGARD
ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELR2008 - 00047
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/3/2008
PARCEL: 1 S136AD -06504
SITE ADDRESS: 11462 SW PACIFIC HWY ZONING: C -
SUBDIVISION: AMERICAS TIRE COMPANY LOT: 003 JURISDICTION: TIG
PROJECT: DISCOUNT TIRE COMPANY
Project Description: Low voltage for HVAC.
A. RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: AUDIO & STEREO: INTERCOM & PAGING:
BURGLAR ALARM: BOILER: LANDSCAPE /IRRIGAT:
GARAGE OPENER: CLOCK: MEDICAL:
HVAC: DATA/TELE COMM: NURSE CALLS:
VACUUM SYSTEM: FIRE ALARM: OUTDOOR LANDSC LITE:
OTHER: : HVAC: X PROTECTIVE SIGNAL:
INSTRUMENTATION: OTHER:
TOTAL # OF SYSTEMS: 1
Owner: Contractor:
HALLE PROPERTIES LLC ARROW MECHANICAL
20225 N SCOTTSDALE RD 10330 SW TUALATIN RD
SCOTTSDALE, AZ 85225 TUALATIN, OR 97062
Phone: Contact #: PRI 503- 692 -1565 •
FEES Reg #: ELE 34 -47CLE
LIC 5193
Description Date Amount
[ELPRMT] ELR Permit 3/3/2008 $75.00
[TAX] 12% State Surch 3/3/2008 $9.00 REQUIRED ITEMS AND REPORTS
Total $84.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon
Utility No • ' ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these
rules direct questions O . at ! • .246.6699 or 1.800.332.2344.
Issu By: I� :,! ,` Permittee Signature: AVM _� d
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR. INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrica Permit ApplicationREC FOR OFFICE USE ONLY
City of Tigard 11�, �� 1p ,at y � ,4 D 8 ^ Permit No ": ra g
° 13125 SW Hall Blvd., Tigard, OR 97223 MAR 9 n Plan Review 7
C ' Phone: 503.639.4171 Fax: 503.598.196 3 COOP Date/By: Other Permit: T 1 G A R D Inspection Line: 503.639 + -I�n n Date Ready/By: to 0 See Page 2 for
B UILD
Internet: www.tigard- or.gov In INp plV IS 9 �P! ` h 1'I I N otified/Method: Me PLAN REVIREVIEW . Supplemental Information
. "
. TYPE OF WORK
® New construction ❑ Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
' CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building
amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
dOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A" "E" "1 -2" "1 -3"
Job no.: Job site address: 11462 SW Pacific Hwy. loot>P or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt- no.: Project name: America's Tire Store ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: FEE SCH QDUI E Fee.
Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential
' DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Thermostat installation Limited energy, multi - family 75.00 2
residential (with above sq. ft")
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
VC P PERTY O R ❑ TENANT . " . 201 amps to 400 amps 106.85 2
Name: Lt � vV io ri t C ) L / 1� _ 401 amps to 600 amps 160.60 2
��" 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date.
A. Fee for branch circuits with
. ❑ APPLICANT 'I ❑ CONTACT' PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: Arrow Mechanical Contractors, Inc. B. Fee for branch circuits
without service or feeder fee,
K
Contact name: Kevin Kruszewski
46.85 2
first branch circuit
Address: 10330 SW Tualatin Road Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Tualatin, OR 97062 Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (503) 692 - 1565 Fax: : (503) 6914879 Reconnect only 66.85 2
E -mail: arrowmech@verizon.net Pump or irrigation circle 53.40 2
.CONTRACTOR . Sign or outline lighting 53.40 2
Business name: Arrow Mechanical Contractors, Inc Signal circuit(s) or limited -
energy panel, alteration, or
Address: 10330 SW Tualatin Road extensionse: 1 Page 2 2
City /State/ZIP: Tualatin, OR 97062 Each ad ihd 'onal inspection over allowable In any of the above
Phone: (503) 692 - 1565 Fax: (503) 691 - 1879 Inv ga nvesstitigation on 62.50
per hour (1 hr min) 62.50
CCB Lic.: 5193 Electrical Lic.: 34 -47CLE Suprv. Lic.: 930LEB Industrial plant per hour 73.75
kje, ELECTR ICAL PERMIT FEES _
: G Suprv. Electrician signature, required Subtotal: (S Print name: Robert C- La Salle Date: 02 /15/2008 Plan review (25% of permit fee): -0—
State surcharge (12% of permit fee): ? , CXJ
Authorized signature: TOTAL PERMIT FEE: gcl 00
Print name: Kevin Kruszewski Date: 02 /15/2008 This permit application expires Ira permit Is not obtained ` within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Pennits\ELC- PemritApp "doc 05/23/06 440- 4615T(ll /05/COM/WEB
CITY OF TIGARD :.
BUILDING DIVISION PERMIT #: F_LR2008.00047
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/3/2008
Phone: (503) 639 -4171 art
Inspection Requests (24 Hrs.): (503) 639 -4175 I �
INSPECTION WORKSHEET FOR DATE: 7/16/2008 TIME: 7:00AM PAGE: 57
SITE ADDRESS: 11462 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: AMERICAS TIRE COMPANY LOT #: 003 TYPE OF USE:
PROJECT NAME: DISCOUNT TIRE COMPANY
DESCRIPTION: Low voltage for HVAC.
OWNER: HALLE PROPERTIES LLC. PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 503 -692 -1565
Inspection Request Scheduled For: Date: 7/16/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 072669 -02 503 -692 -1565 N
�q T J'AL
Corrections /Comments /Instructions:
I �v a
►�' PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: uv P LC Date: 1 , i O% Phone #: (503) 718-
CITY OF TIGARD
'BUILDING DIVISION c PERMIT #: ELR2008.00a47
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/312008
Phone: (503) 639 -4171 M
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 718/2008 TIME: 7:00AM PAGE: 51
1
SITE ADDRESS: 11462 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: AMERICAS TIRE COMPANY LOT #: 003 TYPE OF USE:
PROJECT NAME: DISCOUNT TIRE COMPANY
DESCRIPTION: Low voltage for HVAC.
•
OWNER: HALLE PROPERTIES LLC, PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 503. 692 - 1565
Inspection Request Scheduled For: Date: 7/8/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 072302 -01 503 - 793 -2854 N
Corrections /Comments /Instructions:
❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: VSNNtA Dat e: 7 ' _ Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELR2008- 0f1047
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/3/2008
Phone: (503) 639 -4171 t, ucl l ll
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/30/2008 TIME: 7:00AM PAGE: 21
SITE ADDRESS: 11462 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: AMERICAS TIRE COMPANY LOT #: 003 TYPE OF USE:
PROJECT NAME: DISCOUNT" TIRE COMPANY
DESCRIPTION: Low voltage for HVAC.
OWNER: HALLE PROPERTIES LLC, PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 601692 - 1566
Inspection Request Scheduled For: Date: 6/30/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
135 Low voltage 071997 -01 503 - 692 -1565 N
Corrections /Comments/ Instructions:
j o - p p c, 6/0 0 s i !/f (lam I L
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 11 Date: ""3 0 e Phone #: (503) 718-